急性冠脉综合征患者同型半胱氨酸水平变化及麝香保心丸对其的影响

Level changes of homocysteine in patients with acute coronary syndrome and influence of Shexiang Baoxin pill on it

目的观察急性冠脉综合征(ACS)患者血浆同型半胱氨酸(Hcy)的水平及麝香保心丸治疗对Hcy的影响。方法将90例ACS患者分为非ST段抬高的ACS组和ST段抬高心肌梗死(STEMI)组,另外选取40例劳力性稳定型心绞痛患者(对照组)以及31例体检正常者(正常组)作为对照。采用高效液相色谱法检测各组血浆中Hcy含量。并对比观察部分患者常规药物治疗(41例)与加用麝香保心丸治疗(36例)的疗效及用药前后Hcy含量变化。结果正常组Hcy为(9.90±4.23)μmol/L,STEMI组Hcy为(25.32±4.17)μmol/L,非ST段抬高的ACS组Hcy为(17.91±3.09)μmol/L,STEMI组与非ST段抬高的ACS组或正常组比较,均有显著性差异(P<0.01或P<0.05);对照组Hcy为(11.77±3.99)μmol/L,与正常组比较无显著性差异。麝香保心丸组用药前后Hcy分别为(17.17±3.15)μmol/L和(10.33±3.41)μmol/L(P<0.05),常规治疗组用药前后Hcy分别为(16.88±2.92)μmol/L和(14.55±3.22)μmol/L(P>0.05)。结论Hcy对ACS具有早期诊断和鉴别诊断价值,常规抗凝治疗加用麝香保心丸能更好地降低ACS患者Hcy水平,改善其心肌缺血症状。

Objective It is to observe the level of plasma homocysteine（Hcy） in patients with acute coronary syndrome（ACS） and the influence of Shexiang Baoxin pill（SXBXP） on Hcy.Methods 90 ACS patients were divided into non ST-elevation ACS group and ST-elevation myocardial infarction（STEMI） group.Otherwise 40 cases of exertion stable angina（control group） and 31 cases of healthy people（normal group） were chosen as control.The levels of plasma Hcy in all the groups were detected with high efficiency liquid chromatography.41 cases were treated with routine therapy and 36 cases were treated with SXBXP added.Their curative effects and the content changes of Hcy before and after treatment were observed and compared.Results The level of Hcy in normal group was（9.90±4.23）μmol/L,that in STEMI group was（25.32±4.17）μmol/L,that in non ST-elevation ACS group was（17.91±3.09）μmol/L and that in control group was（11.77±3.99）μmol/L.There were both significant differences between STEMI group and non ST-elevation ACS group or normal group（P〈0.01 or P〈0.05）.There was no significant difference between control group and normal group（P〉0.05）.The level of Hcy in SXBXP group before and after medication was（17.17±3.15）μmol/L and（10.33±3.41）μmol/L respectively and there was significant difference（P〈0.05）.The level of Hcy in routine therapy group before and after medication was（16.88±2.92）μmol/L and（14.55±3.22）μmol/L respectively and there was no significant difference（P〉0.05）.Conclusion Hcy has early diagnostic and differentiated value for ACS.Convention anticoagulant therapy added with SXBXP can better lower Hcy level in ACS patients and improve the symptom of myocardial ischemia.